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Gillebaart M, Schneider IK. Effortless self-control. Curr Opin Psychol 2024; 59:101860. [PMID: 39178788 DOI: 10.1016/j.copsyc.2024.101860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/02/2024] [Accepted: 08/02/2024] [Indexed: 08/26/2024]
Abstract
Self-control is essential for outcomes in several life domains but is often seen as effortful. We discuss recent research indicating the possibility of effortless self-control. First, we discuss how high levels of self-control are associated with quicker self-control conflict identification and resolution. Second, we describe two pathways that may lead to these associations: (1) How automatization of behaviors plays a role in self-control outcomes. That is, self-control is associated with better, effortless habits. (2) We discuss that self-control conflicts can be anticipated and resolved with strategies that avoid effortful inhibition. Taken together, we aim to demonstrate that there is more to successful self-control than 'simply' working hard to resist your impulses - there may be easier roads to take.
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Affiliation(s)
- Marleen Gillebaart
- Utrecht University, Social, Health, and Organisational Psychology, Heidelberglaan 1, 3584CS Utrecht, the Netherlands.
| | - Iris K Schneider
- Dresden University of Technology, Zellescher Weg 17, 01069 Dresden, Germany; Center for Social and Economic Behavior, University of Cologne, Germany
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2
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Chen C, Liu A, Zhang Z, Chen J, Huang H. Digital therapeutics in hypertension: How to make sustainable lifestyle changes. J Clin Hypertens (Greenwich) 2024. [PMID: 39248244 DOI: 10.1111/jch.14894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 07/14/2024] [Accepted: 08/15/2024] [Indexed: 09/10/2024]
Abstract
Various digital therapeutic products have been validated and approved since 2017. They have demonstrated efficacy and safety as a new therapeutic modality in various disorders or conditions. Hypertension is a common but serious condition that can be prevented or controlled with lifestyle changes and medicines. Although a digital therapeutic in hypertension is validated and approved in Japan, whether digital therapeutics (DTx) can significantly improve sustainable lifestyle changes is still a controversial topic. Most studies did not discuss the long-term gain challenges. In this review, the authors discuss the definition of DTx, and analyze the motivation, engagement and adherence challenges of DTx in hypertension. Some ongoing artificial intelligence (AI)-enabled or cognitive behavioral therapy (CBT)-based digital interventions and behavioral strategies for implementing sustainable lifestyle changes are identified and analyzed. With AI-enabled interventions and behavioral strategies, DTx might be one of the effective approaches to make sustainable lifestyle changes.
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Affiliation(s)
- Chaoyi Chen
- Department of Cardiology, Joint Laboratory of Guangdong-Hong Kong-Macao Universities for Nutritional Metabolism and Precise Prevention and Control of Major Chronic Diseases, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Aiting Liu
- Department of Cardiology, Joint Laboratory of Guangdong-Hong Kong-Macao Universities for Nutritional Metabolism and Precise Prevention and Control of Major Chronic Diseases, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Zhengzhipeng Zhang
- Department of Cardiology, Joint Laboratory of Guangdong-Hong Kong-Macao Universities for Nutritional Metabolism and Precise Prevention and Control of Major Chronic Diseases, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Jie Chen
- Department of Radiotherapy, Sun Yatsen Memorial Hospital, Sun Yat-sen University Guangzhou, Guangzhou, China
| | - Hui Huang
- Department of Cardiology, Joint Laboratory of Guangdong-Hong Kong-Macao Universities for Nutritional Metabolism and Precise Prevention and Control of Major Chronic Diseases, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
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3
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Young D, Cawood S, Mares K, Duschinsky R, Hardeman W. Strategies supporting parent-delivered rehabilitation exercises to improve motor function after paediatric traumatic brain injury: A systematic review. Dev Med Child Neurol 2024; 66:836-848. [PMID: 37794644 DOI: 10.1111/dmcn.15773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/04/2023] [Accepted: 09/07/2023] [Indexed: 10/06/2023]
Abstract
AIM To identify and analyse ways in which parents are supported to deliver rehabilitation exercises to their child after traumatic brain injury (TBI), conceptualized as strategies. METHOD A systematic search was completed using seven online databases and three grey literature databases, from inception to November 2021. The included studies focused on physical rehabilitation in children after TBI with the involvement of parents as hands-on deliverers or facilitators of rehabilitation (e.g. supervising the exercise). Intervention descriptions were reviewed to identify strategies; this was followed by fine-grained analysis using the Behaviour Change Wheel to identify intervention components. Risk of bias was analysed using the revised Cochrane Risk-of-Bias Tool for Randomized Trials or the Risk Of Bias In Non-randomized Studies - of Interventions. RESULTS Six interventions including 211 participants and one trial protocol met the inclusion criteria. All studies included a proportion of children diagnosed with TBI and four studies included mixed samples of acquired brain injury or cerebral palsy. All interventions included elements of goal setting and instruction. INTERPRETATION Interventions focus heavily on the initiation of physical rehabilitation, but focus less on the longer-term maintenance of rehabilitation delivery. Further research should integrate perspectives from parents to inform the development of new interventions. WHAT THIS PAPER ADDS Parents need support to deliver or supervise rehabilitation exercises. The interventions identified in this review supported goal setting, action planning, and learning rehabilitation exercises. Interventions focused primarily on the initiation of exercises but less on maintenance. Rehabilitation is complex and new approaches are needed to better support parents.
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Affiliation(s)
- David Young
- School of Health Sciences, University of East Anglia, Norwich, UK
- Women and Children's Services, Addenbrooke's Hospital NHS Foundation Trust, Cambridge, UK
| | - Sarah Cawood
- Women and Children's Services, Addenbrooke's Hospital NHS Foundation Trust, Cambridge, UK
| | - Kathryn Mares
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Robbie Duschinsky
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Wendy Hardeman
- School of Health Sciences, University of East Anglia, Norwich, UK
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Rebar AL, Lagoa CM, Gardner B, Conroy DE. The Specification of a Computational Model of Physical Activity Habit. Exerc Sport Sci Rev 2024; 52:102-107. [PMID: 38865162 PMCID: PMC11178247 DOI: 10.1249/jes.0000000000000340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
The influence of habit on physical activity is computationally modeled as the aggregated influence of past behavioral choices a person makes in a given context. We hypothesize that the influence of habit on behavior can be enhanced through engagement of the target behavior in a particular context or weakened through engagement of alternative behaviors in that context.
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Affiliation(s)
- Amanda L Rebar
- Motivation of Health Behaviours Lab, Appleton Institute, Central Queensland University, Rockhampton, Australia
| | - Constantino Manuel Lagoa
- School of Electrical Engineering and Computer Science, The Pennsylvania State University, State College, PA
| | - Benjamin Gardner
- Habit Application and Theory Group, School of Psychology, University of Surrey, Guildford, United Kingdom
| | - David E Conroy
- Department of Kinesiology, The Pennsylvania State University, State College, PA
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Gifford R, Lacroix K, Asgarizadeh Z, Ashford Anderson E, Milne-Ives M, Sugrue P. Applying the theory of behavioral choice to plant-based dietary intentions. Appetite 2024; 197:107271. [PMID: 38382764 DOI: 10.1016/j.appet.2024.107271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 01/20/2024] [Accepted: 02/13/2024] [Indexed: 02/23/2024]
Abstract
Improving understanding of the intention to choose plant-based food is an important element of climate change mitigation. A cross-sectional survey of 454 North American adults was used to predict their dietary-change intentions from the theory of planned behavior (TPB) and the more-recently proposed theory of behavioral choice (TBC). The TPB accounted for 65 percent of the variance in intentions and the TBC accounted for a significantly greater (80 percent) proportion of variance. The strongest predictors of intention were the TBC's sense of obligation, attitude-values-affect (AVA), and habit, and the TBP's social norms. Five interactions also contributed in small but significant ways toward the accounting of the participants' food-choice intentions. Policy implications are discussed.
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Affiliation(s)
- Robert Gifford
- Department of Psychology, University of Victoria, Victoria, Canada.
| | - Karine Lacroix
- Department of Psychology, University of Victoria, Victoria, Canada
| | | | | | | | - Peter Sugrue
- Department of Psychology, University of Victoria, Victoria, Canada
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6
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Conroy DE, Marks J, Cutshaw A, Ram N, Thomaz E, Streeper NM. Promoting fluid intake to increase urine volume for kidney stone prevention: Protocol for a randomized controlled efficacy trial of the sip IT intervention. Contemp Clin Trials 2024; 138:107454. [PMID: 38253254 PMCID: PMC10923155 DOI: 10.1016/j.cct.2024.107454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/11/2024] [Accepted: 01/19/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Risk of kidney stone recurrence can be reduced by increasing fluid intake and urine production but most patients fail to adhere to recommended clinical guidelines. Patients have indicated that common barriers to fluid intake include a lack of thirst, forgetting to drink, and not having access to water. We developed the sipIT intervention to support patients' fluid intake with semi-automated tracking (via a mobile app, connected water bottle and a smartwatch clockface that detects drinking gestures) and provision of just-in-time text message reminders to drink when they do not meet the hourly fluid intake goal needed to achieve the recommended volume. This trial evaluates the efficacy of sipIT for increasing urine output in patients at risk for recurrence of kidney stones. METHOD/DESIGN Adults with a history of kidney stones and lab-verified low urine production (<2 L/day) will be randomly assigned to receive either usual care (education and encouragement to meet fluid intake guidelines) or usual care plus the sipIT intervention. The primary outcome is 24-h urine volume; secondary outcomes include urinary supersaturations, past week fluid intake, and experienced automaticity of fluid intake. Outcomes will be assessed at baseline, 1 month, 3 months, and 12 months. CONCLUSIONS The sipIT intervention is the first to prompt periodic fluid intake through integration of just-in-time notifications and semi-automated tracking. If sipIT is more efficacious than usual care, this intervention provides an innovative treatment option for patients needing support in meeting fluid intake guidelines for kidney stone prevention.
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Affiliation(s)
- David E Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA.
| | - James Marks
- Department of Urology, The Pennsylvania State University, Hershey, PA 17033, USA
| | - Alyssa Cutshaw
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA
| | - Nilam Ram
- Department of Communication and Psychology, Stanford University, Palo Alto, CA 94305, USA
| | - Edison Thomaz
- Department of Electrical and Computer Engineering, University of Texas, Austin, TX 78712, USA
| | - Necole M Streeper
- Department of Urology, The Pennsylvania State University, Hershey, PA 17033, USA
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Timkova V, Minarikova D, Fabryova L, Buckova J, Minarik P, Katreniakova Z, Nagyova I. Facilitators and barriers to behavior change in overweight and obesity management using the COM-B model. Front Psychol 2024; 15:1280071. [PMID: 38455118 PMCID: PMC10919221 DOI: 10.3389/fpsyg.2024.1280071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 02/05/2024] [Indexed: 03/09/2024] Open
Abstract
Introduction Increasing overweight and obesity rates represent one of the global public health challenges. COM-B is a theoretical model used to identify areas to target to achieve behavior change. It identifies three factors that are needed for any behavior to occur: capability, opportunity, and motivation. We aimed to assess the potential facilitators and barriers to behavior change in weight management using the COM-B. Methods The study included 139 people with overweight and obesity (mean age 48.81 ± 14.49 years; 64.5% female; body mass index 32.64 ± 6.51 kg/m2; waist-to-height ratio 0.62 ± 0.10) from primary care settings. All participants completed the Brief Measure of Behavior Change (COM-B), the General Self-Efficacy Scale (GSE), the Rosenberg Self-esteem Scale (RSE), and the Overall Evaluation of Health (OEH). Multiple linear regression was performed to analyse the data. Results The associations between sociodemographic and clinical variables and COM-B domains attenuated or were no longer significant when psychological resources were added to the regression models. Self-efficacy was identified as a stronger facilitator of health behavior change (p < 0.001) when compared to self-esteem (p < 0.05). No associations between automatic motivation and psychological resources were identified, however. Automatic motivation was found to be associated with higher age, being in a relationship, and better health. Discussion Behavioral interventions for weight management should specifically target different components of COM-B. Self-efficacy and self-esteem may play a significant role in individual capabilities, opportunities, and reflective motivation and should be included in tailored public health interventions. Health programs targeting younger and single people, and people with chronic conditions may help to promote sustainable behavior change.
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Affiliation(s)
- Vladimira Timkova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef (PJ) Safarik University in Kosice, Kosice, Slovakia
| | - Daniela Minarikova
- Department of Organisation and Management of Pharmacy, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia
| | - Lubomira Fabryova
- Biomedical Research Centre of the Slovak Academy of Sciences, Bratislava, Slovakia
- Institute for Prevention and Intervention, St. Elisabeth University of Health and Social Work, Bratislava, Slovakia
- Faculty of Nursing and Medical Professional Studies, Slovak Health University, Bratislava, Slovakia
| | - Jana Buckova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef (PJ) Safarik University in Kosice, Kosice, Slovakia
| | - Peter Minarik
- Biomedical Research Centre of the Slovak Academy of Sciences, Bratislava, Slovakia
- Institute for Prevention and Intervention, St. Elisabeth University of Health and Social Work, Bratislava, Slovakia
| | - Zuzana Katreniakova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef (PJ) Safarik University in Kosice, Kosice, Slovakia
| | - Iveta Nagyova
- Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef (PJ) Safarik University in Kosice, Kosice, Slovakia
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Imhagen A, Karlsson J, Ohlsson-Nevo E, Stenberg E, Jansson S, Hagberg L. Levels of Physical Activity, Enjoyment, Self-Efficacy for Exercise, and Social Support Before and After Metabolic and Bariatric Surgery: a Longitudinal Prospective Observational Study. Obes Surg 2023; 33:3899-3906. [PMID: 37837533 PMCID: PMC10687134 DOI: 10.1007/s11695-023-06887-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/29/2023] [Accepted: 10/04/2023] [Indexed: 10/16/2023]
Abstract
INTRODUCTION Physical activity (PA) after metabolic and bariatric surgery (MBS) can influence weight loss, health status, and quality of life. Known mediators to participate in PA are enjoyment, self-efficacy, and social support. Little is known about PA behavior in MBS individuals. The aim of this study was to explore levels of PA and the PA mediators enjoyment, self-efficacy, and social support before and after MBS and to investigate changes over time. METHODS Adults scheduled to undergo MBS were recruited from a Swedish university hospital. Accelerometer-measured and self-reported PA, body weight, and PA mediators were collected at baseline and at 12 to 18 months post-surgery. RESULTS Among 90 individuals included, 50 completed the follow-up assessment and had valid accelerometer data. Sedentary time (minutes/day) was unchanged, but sedentary time as percentage of wear time decreased significantly from 67.2% to 64.5% (p<0.05). Time spent in light PA and total PA increased significantly from 259.3 to 288.7 min/day (p < 0.05) and from 270.5 to 303.5 min/day (p < 0.01), respectively. Step counts increased significantly from 6013 to 7460 steps/day (p < 0.01). There was a significant increase in self-reported PA, enjoyment, self-efficacy for exercise, and positive social support from family. The increase in PA mediators did not lead to a significant change in time spent in moderate to vigorous PA. CONCLUSION The increase in PA-mediators was not associated with an increase in moderate to vigorous PA, but the strengthened PA mediators suggest potential for an increase in moderate to vigorous PA in patients undergoing MBS.
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Affiliation(s)
- Annika Imhagen
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden.
| | - Jan Karlsson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden
| | - Emma Ohlsson-Nevo
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden
- Department of Surgery, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden
| | - Erik Stenberg
- Department of Surgery, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden
- School of Medical Sciences, Örebro University, SE-701 82, Örebro, Sweden
| | - Stefan Jansson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden
| | - Lars Hagberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden
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Krouwel M, Greenfield SM, Chalkley A, Sanders JP, Parretti HM, Gokal K, Jolly K, Skrybant M, Biddle SJH, Greaves C, Maddison R, Mutrie N, Ives N, Esliger DW, Sherar L, Edwardson CL, Yates T, Frew E, Tearne S, Daley AJ. Promoting participation in physical activity through Snacktivity: A qualitative mixed methods study. PLoS One 2023; 18:e0291040. [PMID: 37695785 PMCID: PMC10495025 DOI: 10.1371/journal.pone.0291040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/21/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Public health guidance acknowledges the benefits of physical activity of any duration. We have proposed a whole-day approach to promoting physical activity called Snacktivity™, which encourages frequent 2-5 minute 'activity snacks' of moderate-to-vigorous intensity. METHODS Using repeated semi-structured interviews and a think aloud protocol, this study aimed to understand participants' experiences of integrating Snacktivity™ into daily life, to provide insights to refine the delivery of Snacktivity™ interventions. Physically inactive adults recruited via primary care and a community health service engaged with an intervention to encourage Snacktivity™ over three weeks, which included using a Fitbit and linked mobile phone app (SnackApp). Participants took part in semi-structured interviews on two occasions during the intervention, with a sub-group participating in a think aloud study. Three study data sets were generated and independently explored using inductive thematic analysis, with findings combined into a single set of themes. RESULTS Eleven adults participated in the interview study who were interviewed twice (total interviews completed n = 21, 1 participant declined the second interview), of whom six completed the think aloud study (total voice recordings n = 103). Three main themes emerged from the combined data; lived experience of participating in Snacktivity™, motivation for Snacktivity™ and experiences with the Snacktivity™ technology. Participants undertook a variety of activity snacks, utilising their environment, which they believed improved their psychological wellbeing. Participants were enthusiastic about Snacktivity™, with some stating that activity snacks were more accessible than traditional exercise, but perceived they were often prevented from doing so in the presence of others. Participants were mostly enthusiastic about using the Snacktivity™ technology. CONCLUSION Participants were able to incorporate Snacktivity™ into their lives, particularly at home, and found this approach acceptable. Participants felt they experienced health benefits from Snacktivity™ although barriers to participation were reported. This study offers insights for translating guidance into practice and supporting people to become more physically active.
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Affiliation(s)
- Matthew Krouwel
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Sheila M. Greenfield
- Institute for Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Anna Chalkley
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - James P. Sanders
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Helen M. Parretti
- Norwich Medical School, Faculty of Medicine and Health, University of East Anglia, Norwich, United Kingdom
| | - Kajal Gokal
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Kate Jolly
- Institute for Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Magdalena Skrybant
- Institute for Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Stuart J. H. Biddle
- University of Southern Queensland, Springfield, Australia and Faculty of Sport & Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Colin Greaves
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Natalie Ives
- Birmingham Clinical Trials Unit, Institute for Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Dale W. Esliger
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Lauren Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Charlotte L. Edwardson
- Diabetes Research Centre, College of Life Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, Leicester, United Kingdom
| | - Tom Yates
- Diabetes Research Centre, College of Life Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, Leicester, United Kingdom
| | - Emma Frew
- Health Economics Unit, Institute for Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Sarah Tearne
- Birmingham Clinical Trials Unit, Institute for Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Amanda J. Daley
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
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Western MJ, Welsh T, Keen K, Bishop V, Perkin OJ. Exercise snacking to improve physical function in pre-frail older adult memory clinic patients: a 28-day pilot study. BMC Geriatr 2023; 23:471. [PMID: 37542234 PMCID: PMC10403822 DOI: 10.1186/s12877-023-04169-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/13/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Finding innovative yet feasible ways of preventing physical and cognitive decline in those at risk is a critical global challenge, with exercise being championed as a key precursor to robust health in later life. Exercise snacking, here defined as short bouts of sporadic [muscle-strengthening] exercise, is one such strategy designed to overcome typical participation barriers observed in older adults. This study examined the acceptability of exercise snacking amongst pre-frail older adults and explored the efficacy of this approach in improving physical function. METHODS In this single group design, 21 pre-frail outpatients with mild-cognitive impairment were recruited from a UK memory clinic. To be eligible, participants were aged ≥ 65-years who scored 3-8 (inclusive) on the short physical performance battery (SPPB) and were not regularly engaging in sport or exercise. Participants completed a 28-day, twice daily, exercise snacking intervention, consisting of five muscle-strengthening exercises, with the aim being to complete as many repetitions as possible of each exercise in a minute. Acceptability of the intervention was measured quantitatively and qualitatively using a survey and topic guide informed by the Theoretical Framework of Acceptability. Pre- and post-intervention physical function was measured using the SPPB, timed up-and-go (TUG), and 60s standing balance and sit-to-stand tests. RESULTS Eighteen participants provided follow-up data and showed 85% adherence to the exercise snacking intervention, measured as the proportion of all sessions completed out of a possible 56. Participants rated the intervention as highly acceptable (4.6/5) suggesting it supported their self-efficacy (4.3/5) was enjoyable (4.1/5) and had a low burden (2.1/5). Qualitative findings suggested the ease of use, flexibility of the programme, and perceived effectiveness was important, and particularly useful for non-exercisers. Changes in SPPB score (8(1) vs. 9(3), p < 0.01), TUG (11.32(4.02) vs. 9.18(5.25) seconds, p < 0.01) and in the 60-second sit-to-stand test (17 ± 5 vs. 23 ± 7 repetitions, p < 0.01) were seen between baseline and follow-up. CONCLUSIONS Exercise snacking is an acceptable and potentially efficacious format of exercise for pre-frail memory clinic attendees who are at heightened risk of falling and frailty. Large scale randomised controlled trials are required to confirm whether exercise snacking is effective in the short and long term. CLINICALTRIALS GOV REGISTRATION NCT05439252 (30/06/2022).
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Affiliation(s)
- Max J Western
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, BA2 7AY, UK.
| | - Tomas Welsh
- Research Institute for Care of Older People, The RICE Centre, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK
- University of Bristol, Bristol, BS8 1QU, UK
- Royal United Hospitals Bath NHS Foundation Trust, Bath, BA1 3NG, UK
| | - Kristen Keen
- Research Institute for Care of Older People, The RICE Centre, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK
| | - Vanessa Bishop
- Research Institute for Care of Older People, The RICE Centre, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK
| | - Oliver J Perkin
- Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, Bath, BA2 7AY, UK
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Halkier B, Lund TB. Exploring everyday life dynamics in meat reduction - A cluster analysis of flexitarians in Denmark. Appetite 2023; 183:106487. [PMID: 36746276 DOI: 10.1016/j.appet.2023.106487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/06/2023]
Abstract
Exploring everyday life dynamics in meat reduction - a cluster analysis of flexitarians in Denmark. Flexitarians are attracting increasing attention in the research on meat reduction. But there has been limited focus on comprehensive understandings of a broader range of dynamics that can work as barriers and facilitators for meat reduction. In this article, we use social practice theory (SPT) as a comprehensive approach to barriers and facilitators in meat reduction in everyday life. We present an analysis of data from a representative Danish cross-sectional survey. We show, first, that Danish flexitarians can be divided into four distinct clusters (what we will refer to as classes) in accordance with combinations of everyday facilitators and barriers. Second, we show that the prevalence of these classes varies considerably depending on how long people have been flexitarians. We argue that the patterns in this variation indicate that over time people transition to other classes where barriers to plant-rich eating become less significant, and routinization emerges in different ways. Finally, third, we show that flexitarians do report eating less meat than consumers who label themselves as eating meat with no restrictions. But we also highlight that the difference is relatively modest. Indeed, meat intake is still quite common even in classes where routinization is highest. Throughout the paper, we discuss similarities and differences between the SPT framework and another recent framework, the COM-B model, that also provides a comprehensive approach to the understanding of behavioural change.
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Affiliation(s)
- Bente Halkier
- Department of Sociology, University of Copenhagen, Denmark.
| | - Thomas Bøker Lund
- Department of Food and Resource Economics, University of Copenhagen, Denmark.
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Rebar AL, Lally P, Verplanken B, Diefenbacher S, Kwasnicka D, Rhodes RE, Lanzini P, Koutoukidis DA, Venema TAG, Gardner B. Changes in virus-transmission habits during the COVID-19 pandemic: a cross-national, repeated measures study. Psychol Health 2022; 37:1626-1645. [PMID: 35899368 PMCID: PMC9615635 DOI: 10.1080/08870446.2022.2097682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 05/25/2022] [Accepted: 06/29/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The COVID-19 pandemic saw promotion of novel virus transmission-reduction behaviours, and discouragement of familiar transmission-conducive behaviours. Understanding changes in the automatic nature of such behaviours is important, because habitual behaviours may be more easily reactivated in future outbreaks and disrupting old habits may discontinue unwanted behaviours. DESIGN A repeated-measures, multi-national design tracked virus-transmission habits and behaviour fortnightly over six months (Apr-Sept 2020) among 517 participants (age M = 42 ± 16y, 79% female). MAIN OUTCOME MEASURES Within-participant habit trajectories across all timepoints, and engagement in transmission-reduction behaviours (handwashing when entering home; handwashing with soap for 20 seconds; physical distancing) and transmission-conducive behaviours (coughing/sneezing into hands; making physical contact) summed over the final two timepoints. RESULTS Three habit trajectory types were observed. Habits that remained strong ('stable strong habit') and habits that strengthened ('habit formation') were most common for transmission-reduction behaviours. Erosion of initially strong habits ('habit degradation') was most common for transmission-conducive behaviours. Regression analyses showed 'habit formation' and 'stable strong habit' trajectories were associated with greater behavioural engagement at later timepoints. CONCLUSION Participants typically maintained or formed transmission-reduction habits, which encouraged later performance, and degraded transmission-conducive habits, which decreased performance. Findings suggest COVID-19-preventive habits may be recoverable in future virus outbreaks.
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Affiliation(s)
- Amanda L. Rebar
- School of Health, Medical, and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Phillippa Lally
- Research Department of Behavioural Science and Health, University College London, London, UK
| | | | - Svenne Diefenbacher
- Department of Social Psychology, Ulm University, Ulm, Germany
- Department of Social Monitoring and Methodology, German Youth Institute, Munich, Germany
| | - Dominika Kwasnicka
- NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, University of Melbourne, Melbourne, Australia
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warszawa, Poland
| | - Ryan E. Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, Canada
| | - Pietro Lanzini
- Department of Management, Ca’ Foscari University, Venice, Italy
| | - Dimitrios A. Koutoukidis
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Tina A. G. Venema
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Benjamin Gardner
- Department of Psychology, King’s College London, London, UK
- Department of Psychology, University of Surrey, Guildford, UK
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Diefenbacher S, Lally P, Gardner B. Habit formation in context: Context‐specific and context‐free measures for tracking fruit consumption habit formation and behaviour. Br J Health Psychol 2022; 28:499-512. [PMID: 36437536 DOI: 10.1111/bjhp.12637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 11/14/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Interventions promoting habitual fruit consumption have the potential to bring about long-term behaviour change. Assessing the effectiveness of such interventions requires adequate habit and behaviour measures. Habits are based on learned context-behaviour associations, so measures that incorporate context should be more sensitive to expected habit and behaviour changes than context-free measures. This study compared context-specific and context-free measures of fruit consumption habit and behaviour following a 3-week habit formation intervention. DESIGN Prospective online study (n = 58). METHODS Behaviour frequency was assessed across five timepoints, retrospectively (Time 1 [T1], T5) or via daily diary data (uploaded weekly at T2, T3 and T4). Habit strength was assessed before (T1) and immediately after the intervention (T4), and again 2 weeks later (T5). Analyses of variance were run, with time and context specificity as within-subject factors, and habit and behaviour frequency as dependent measures. RESULTS An interaction between time and context specificity was found in both analyses (habit: F(2,114) = 12.848, p < .001, part.η2 = .184; behaviour: F(2,114) = 6.714, p = .002, part.η2 = .105). Expected habit formation patterns 5 weeks post-baseline were only detected by the context-specific habit measure. Likewise, increased behaviour frequency was only found when the target context was specified (p's < .001). CONCLUSIONS Assessments of purposeful dietary habit and behaviour change attempts should incorporate context-specific measurement.
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Affiliation(s)
| | - Phillippa Lally
- Research Department of Behavioural Science and Health University College London London UK
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Segar M. It's Time to Unhabit and Think Critically About Whether Habit Formation Has Been Over Valued as a Behavior Change Strategy Within Health Promotion. Am J Health Promot 2022; 36:1418-1420. [PMID: 36305500 DOI: 10.1177/08901171221125326f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Johnson SS. Knowing Well, Being Well: well-being born of understanding: Editor’s Desk: It’s Critical to Cultivate Intellectual Humility. Am J Health Promot 2022; 36:1399-1420. [DOI: 10.1177/08901171221125326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Weyland S, Fritsch J, Feil K, Jekauc D. Investigating the relation between positive affective responses and exercise instigation habits in an affect-based intervention for exercise trainers: A longitudinal field study. Front Psychol 2022; 13:994177. [PMID: 36211848 PMCID: PMC9540191 DOI: 10.3389/fpsyg.2022.994177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/31/2022] [Indexed: 11/23/2022] Open
Abstract
The present study contains an affect-based intervention intended to support exercise trainers in positively influencing their course participants' affective responses to their exercise courses. We argue that positive affective responses are associated with habit formation, thereby being a promising approach for avoiding high drop-out rates in exercise courses. First, the present study aimed to investigate whether the intervention for exercise trainers could increase (a) affective attitudes, and (b) exercise instigation habit strength, and influence the development of (c) weekly measured affective responses and (d) automaticity among adult participants of exercise courses. Second, it examined the relationship between the development of affective responses and exercise instigation habit strength. Ten exercise trainers of weekly sports and exercise courses at a German university received either an affect-based intervention or a control intervention. 132 of their course participants answered the Self-Report Habit Index (SRHI; the automaticity sub-scale SRBAI was also analyzed) for exercise instigation habit strength and items to measure affective attitude in the initial and final assessment. Moreover, they were assessed for a duration of 10 weeks during which, each time after attending the course, they reported their affective response to exercise as well as their automaticity in arriving at the decision to exercise. In the repeated measures ANOVA, there was a significant main effect of time for exercise instigation habit strength. Overall, habit strength was higher in the final than in the initial assessment. However, there were no significant differences between the two conditions in all study variables. In the latent growth curve model, the trajectory of the latent growth curve of valence was a significant predictor of the final exercise instigation habit strength. While the applied affect-based intervention was not successful in enhancing positive affective responses to exercise, the results indicate that positive affective responses may contribute to strengthening exercise instigation habits. Future studies should examine the effectiveness of interventions in long-term study designs.
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Affiliation(s)
- Susanne Weyland
- Department of Health Education and Sports Psychology, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Kilb M, Labudek S. Effects of behavioral performance, intrinsic reward value, and context stability on the formation of a higher-order nutrition habit: an intensive longitudinal diary study. Int J Behav Nutr Phys Act 2022; 19:105. [PMID: 35962435 PMCID: PMC9372943 DOI: 10.1186/s12966-022-01343-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 07/28/2022] [Indexed: 01/04/2023] Open
Abstract
Background Habits drive many of our health behaviors in our daily lives. However, little is known about the relative contribution of different key factors for habit formation in real-world contexts. We examined the effects of behavioral performance, intrinsic reward value (operationalized as tastiness), and context stability on the formation of a higher-order nutrition habit. Methods Participants were recruited via mailing lists and posts on social media platforms. N = 199 participants (Mage = 37.10 years, SD = 13.00, 86.93% female) received an online intervention for building the higher-order habit of filling half of their plates with vegetables at dinner and completed one daily online survey for up to 56 days, including the assessment of habit strength, behavioral performance, intrinsic reward value, and context stability, providing a total of N = 6352 daily measurements. N = 189 participants (N = 4175 measurements) could be included in the primary analysis. Utilizing multilevel modeling, we analyzed the impact of behavioral performance, intrinsic reward value, and context stability, as well as their interaction effects, on habit strength on the next day. Results Habit strength significantly increased over time. This effect was strengthened in persons with high mean levels of behavioral performance. Furthermore, mean levels of behavioral performance, intrinsic reward value, and context stability were all positively related to mean levels of habit strength. There were no positive effects of daily intraindividual variations in the three examined factors on habit strength at the next day. There was an unexpected negative effect of daily behavioral performance on habit strength at the next day. We found little to no evidence for our expected and pre-registered interaction effects. In an additional exploratory analysis, there were positive effects of daily intraindividual variations in the three factors on habit strength at the same day. Conclusions We found that behavioral performance, intrinsic reward value, and context stability were all independent predictors of habit strength of a higher-order habit at the between-person level. However, we did not find the expected associations at the within-person level. Habit interventions should promote the consistent performance of the target behaviors in stable contexts. Trial registration https://aspredicted.org/blind.php?x=vu2cg4. Registered 28.04.2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01343-8.
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Affiliation(s)
- Michael Kilb
- Department of Psychology, School of Social Sciences, University of Mannheim, L13, 17, 68161, Mannheim, Germany. .,Department of Child Nutrition, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Haid-und-Neu-Straße 9, 76131, Karlsruhe, Germany.
| | - Sarah Labudek
- Network Aging Research, Heidelberg University, Bergheimer Straße 20, 69115, Heidelberg, Germany
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